Background: Higher heart rate is associated with mortality, whereas its association with clinical cardiovascular events is much more challenged.
Methods: A prospective study was conducted for 169,871 Chinese adults ≥40 years in 1991 and followed during 1999-2000 with a response rate of 93.4%. Hazard ratios (HRs) were estimated by Cox proportional hazard regression model. Cardiovascular disease (CVD) was defined as diagnosis of acute myocardial infarction or stroke or death due to CVD (International Classification of Diseases, Ninth Revision: 390.0-398.9, 401.0-429.9 and 430.0-438.9).
Results: After an average of 8.3 years' follow-up (836,811 person-years), 6837 participants (3932 men, 2905 women) developed CVD. Compared with the participants with heart rate 60-74 beats per minute (bpm), heart rate 75-89 and ≥90 bpm in men increased the risk of CVD after multivariate adjustment, with corresponding HRs [95% confidence intervals (CIs)] 1.12 (1.04-1.20) and 1.32 (1.18-1.47). Heart rate ≥90 bpm increased women's risk of CVD with HR (95% CI) 1.23 (1.09-1.38). Heart rate ≥75 bpm in men increased the risk of heart disease. Heart rate ≥90 bpm increased the risks of coronary heart disease (CHD) and stroke in men, and the risks of heart disease and CHD in women.
Conclusions: Elevated heart rate was associated with high CVD incidence in Chinese adults. This suggests that higher heart rate might be a risk marker for CVD in Chinese adults.